FURP.ORG / PUBLIC DATA EXPLORER

MONTGOMERY GENERAL HOSPITAL INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
MONTGOMERY GENERAL HOSPITAL INC (EIN 55-0372580)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-14
IRS object ID
202233189349309178
Schema version
2021v4.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2022-11-14T12:52:00-06:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390859910PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BAKER TILLY US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1101 WASHINGTON STREET EASTAddressLine1Txt
CityCHARLESTONCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25329ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN550372580EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MONTGOMERY GENERAL HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMONTBusinessNameControlTxt
Phone3044425151PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 SIXTH AVENUEAddressLine1Txt
CityMONTGOMERYCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25136ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSHERRI MURRAYPersonNm
Person TitleCFOPersonTitleTxt
Phone3044421246PhoneNum
Signature2022-11-11SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstSHERRIPersonFirstNm
Person LastMURRAYPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDOLORES ROSEPreparerPersonNm
PTINP01286262PTIN
Phone3043460441PhoneNum
Preparation2022-11-11PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDEBORAH HILLPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 SIXTH AVENUEAddressLine1Txt
CityMONTGOMERYCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25136ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$32,309,141GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MGHWV.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1970FormationYr
Legal Domicile StateWVLegalDomicileStateCd
Activity Or MissionTO PROVIDE QUALITY, COST-EFFECTIVE, AND CONVENIENT HEALTHCARE SERVICES THAT MEET AND EXCEED REASONABLE INTERNAL AND EXTERNAL CUSTOMER EXPECTATIONS.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee350TotalEmployeeCnt
Total Volunteers25TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$4,360,636PYContributionsGrantsAmt
CY Contributions Grants$2,793,360CYContributionsGrantsAmt
PY Program Service Revenue$19,042,953PYProgramServiceRevenueAmt
CY Program Service Revenue$28,253,237CYProgramServiceRevenueAmt
PY Investment Income$24,151PYInvestmentIncomeAmt
CY Investment Income$31,940CYInvestmentIncomeAmt
PY Other Revenue$1,723,666PYOtherRevenueAmt
CY Other Revenue$1,230,604CYOtherRevenueAmt
PY Total Revenue$25,151,406PYTotalRevenueAmt
CY Total Revenue$32,309,141CYTotalRevenueAmt
PY Grants And Similar Paid$350PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$4,000CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$12,719,737PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$13,654,735CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$12,044,805PYOtherExpensesAmt
CY Other Expenses$15,083,111CYOtherExpensesAmt
PY Total Expenses$24,764,892PYTotalExpensesAmt
CY Total Expenses$28,741,846CYTotalExpensesAmt
PY Revenues Less Expenses$386,514PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,567,295CYRevenuesLessExpensesAmt
Total Assets BOY$9,152,395TotalAssetsBOYAmt
Total Assets EOY$13,407,051TotalAssetsEOYAmt
Total Liabilities BOY$8,867,257TotalLiabilitiesBOYAmt
Total Liabilities EOY$8,740,462TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$285,138NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$4,666,589NetAssetsOrFundBalancesEOYAmt
MissionMONTGOMERY GENERAL HOSPITAL IS A CRITICAL ACCESS HOSPITAL. IT ALSO PROVIDES OUTPATIENT SERVICES INCLUDING LABORATORY, RADIOLOGY, SURGERY AND THERAPY SERVICES; PHYSICIAN SERVICES; AND SKILLED NURSING SERVICES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$22,404,158ExpenseAmt
Grant$4,000GrantAmt
Revenue$29,483,841RevenueAmt
DescTHE HOSPITAL PROVIDED HEALTH CARE SERVICES INCLUDING 2,724 ACUTE INPATIENT DAYS; 10,382 SKILLED NURSING DAYS; 18,012 OUTPATIENT VISITS; 6,910 EMERGENCY ROOM VISITS; 727 AMBULATORY SURGERY PROCEDURES; AND 16,714 PHYSICIAN OFFICE VISITS. CHARGES FOREGONE FOR CHARITY CARE AMOUNTED TO $117,492.Desc
Total Program Service Expenses$22,404,158TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document49IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee350EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SHERRI MURRAYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3044421246PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 SIXTH AVENUEAddressLine1Txt
CityMONTGOMERYCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25136ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
RALEIGH COLLINS
TRUSTEE0.501.50Yes (X)$600$0$0
GHASSAN Y DAGHER MD
CHAIR0.501.50Yes (X)$600$0$0Yes (X)
JOYCE BROWN
SECRETARY0.501.50Yes (X)$600$0$0Yes (X)
BARBARA CRIST
VICE-CHAIR0.500.50Yes (X)$800$0$0
VICKIE GAY
PRESIDENT & CEO39.500.50Yes (X)$145,809$0$6,264Yes (X)
RITA BOHANNA
TRUSTEE0.501.50Yes (X)$800$0$0
DONALD SMITH
TRUSTEE0.501.50Yes (X)$800$0$0
PATRICIA TUCKER
TRUSTEE0.501.50Yes (X)$600$0$0
LOU ANN BOWEN
TRUSTEE0.501.50Yes (X)$800$0$0
DEANNE VALENTINE
TRUSTEE0.501.50Yes (X)$600$0$0
SHERRI MURRAY
CFO39.500.50$115,971$0$5,000Yes (X)
ROBERT EGGLESTON MD
PHYSICIAN40.00$301,874$0$0Yes (X)
MYRA PRIDDY MD
PHYSICIAN40.00$245,547$0$0Yes (X)
MOHAMAD SANKARI MD
PHYSICIAN40.00$255,346$0$0Yes (X)
DILIP GHODASARA MD
PHYSICIAN40.00$325,700$0$0Yes (X)
WILLIAM CASTO MD
PHYSICIAN40.00$394,514$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,790,961TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$11,264TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K12IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ADVANTAGE REHAB
150 HIDDEN VALLEY ROADSCOTT DEPOTWV25560THERAPY SERVICES$1,259,862
MEDICAL INFORMATION TECHNOLOGY INC
MEDITECH CIRCLEWESTWOODMA02090EMR SERVICES$599,301
KANAWHA VALLEY RADIOLOGISTS
PO BOX 3428CHARLESTONWV25334RADIOLOGIST SERVICES$468,099
SHARP ANESTHESIA
PO BOX 88FAYETTEVILLEWV25840ANESTHESIA SERVICES$189,073
ARNETT CARBIS TOOTHMAN
PO BOX 45723BALTIMOREMD21297PHARMACY VENDOR$172,987
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K7CntrctRcvdGreaterThan100KCnt
All Other Contributions$2,793,360AllOtherContributionsAmt
Total Contributions$2,793,360TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVICESDesc
Business622110BusinessCd
Total Revenue Column$28,253,237TotalRevenueColumnAmt
Related Or Exempt Func Income$28,253,237RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$28,253,237TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$17,140TotalRevenueColumnAmt
Exclusion$17,140ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$14,800OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$14,800OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$14,800TotalRevenueColumnAmt
Exclusion$14,800ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
340B PROGRAM900099$1,191,406$1,191,406
CAFETERIA722210$33,425$33,425

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,773TotalRevenueColumnAmt
Related Or Exempt Func Income$5,773RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$1,230,604OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$32,309,141TotalRevenueColumnAmt
Related Or Exempt Func Income$29,483,841RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$31,940ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$4,000TotalAmt
Program Services$4,000ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$292,387TotalAmt
Program Services$209,890ProgramServicesAmt
Management And General$82,497ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$11,265,678TotalAmt
Program Services$8,087,085ProgramServicesAmt
Management And General$3,178,593ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$223,758TotalAmt
Program Services$160,625ProgramServicesAmt
Management And General$63,133ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,093,778TotalAmt
Program Services$785,170ProgramServicesAmt
Management And General$308,608ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$779,134TotalAmt
Program Services$559,303ProgramServicesAmt
Management And General$219,831ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$158,258TotalAmt
Management And General$158,258ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$149,132TotalAmt
Management And General$149,132ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,333,925TotalAmt
Program Services$2,393,263ProgramServicesAmt
Management And General$940,662ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$36,120TotalAmt
Program Services$25,929ProgramServicesAmt
Management And General$10,191ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$466,621TotalAmt
Program Services$334,965ProgramServicesAmt
Management And General$131,656ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$804,831TotalAmt
Program Services$577,749ProgramServicesAmt
Management And General$227,082ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,171,719TotalAmt
Program Services$841,120ProgramServicesAmt
Management And General$330,599ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$31,980TotalAmt
Program Services$22,957ProgramServicesAmt
Management And General$9,023ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$20,887TotalAmt
Management And General$20,887ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$555,906TotalAmt
Program Services$399,058ProgramServicesAmt
Management And General$156,848ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$606,054TotalAmt
Program Services$435,057ProgramServicesAmt
Management And General$170,997ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
BAD DEBTS$3,717,715$3,717,715
MEDICAL SUPPLIES$2,875,924$2,875,924
HEALTH CARE PROVIDER TA$517,172$517,172
DUES AND SUBSCRIPTIONS$200,966$144,264$56,702

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$435,901TotalAmt
Program Services$312,912ProgramServicesAmt
Management And General$122,989ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$28,741,846TotalAmt
Program Services$22,404,158ProgramServicesAmt
Management And General$6,337,688ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$3,473,176BOYAmt
EOY$4,806,583EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,072,572BOYAmt
EOY$4,955,865EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$492,552BOYAmt
EOY$646,415EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$88,485BOYAmt
EOY$27,536EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$32,841,194LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$30,150,659LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,699,815BOYAmt
EOY$2,690,535EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$325,795BOYAmt
EOY$280,117EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$9,152,395BOYAmt
EOY$13,407,051EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,278,769BOYAmt
EOY$2,997,552EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$247,794BOYAmt
EOY$269,960EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,340,694BOYAmt
EOY$5,472,950EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,867,257BOYAmt
EOY$8,740,462EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$285,138BOYAmt
EOY$4,666,589EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$285,138BOYAmt
EOY$4,666,589EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$9,152,395BOYAmt
EOY$13,407,051EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$3,567,295ReconcilationRevenueExpnssAmt
Prior Period Adjustments$101,663PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$712,493OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$869,878OtherCostOrOtherBasisAmt
Book Value$869,878BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$12,175,288OtherCostOrOtherBasisAmt
Depreciation$12,026,806DepreciationAmt
Book Value$148,482BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$19,417,313OtherCostOrOtherBasisAmt
Depreciation$17,745,138DepreciationAmt
Book Value$1,672,175BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$378,715OtherCostOrOtherBasisAmt
Depreciation$378,715DepreciationAmt
Book Value$0BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$2,690,535TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
ACCRUED PENSION OBLIGATION$1,858,397
DUE TO THIRD PARTY PAYERS$1,664,101
PPP LOAN$1,950,452
FieldValueIRS element (for citing)
Total Liability$5,472,950TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT OF THE ORGANIZATION TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION. MANAGEMENT HAS EVALUATED THE ORGANIZATION'S TAX POSITIONS AND CONCLUDED THAT THE ORGANIZATION HAS MAINTAINED ITS TAX EXEMPT STATUS AND HAS TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THEREFORE, NO PROVISION OR LIABILITY FOR INCOME TAXES HAS BEEN INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. GENERALLY, TAX RETURNS FOR YEARS ENDED DECEMBER 31, 2018, AND THEREAFTER REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other120.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other120.000000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance Budget0FinancialAssistanceBudgetInd
Annual Community Bnft Report0AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$546,602TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$546,602DirectOffsettingRevenueAmt

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,014,135TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,448,679DirectOffsettingRevenueAmt
Net Community Benefit Expns$565,456NetCommunityBenefitExpnsAmt
Total Expense0.02260TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,560,737TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,995,281DirectOffsettingRevenueAmt
Net Community Benefit Expns$565,456NetCommunityBenefitExpnsAmt
Total Expense0.02260TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$4,000NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$4,000NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,564,737TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,995,281DirectOffsettingRevenueAmt
Net Community Benefit Expns$569,456NetCommunityBenefitExpnsAmt
Total Expense0.02280TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$3,717,715BadDebtExpenseAmt
Reimbursed By Medicare$3,812,536ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$3,812,536CostOfCareReimbursedByMedcrAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MONTGOMERY GENERAL HOSPITAL INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 SIXTH AVENUEAddressLine1Txt
CityMONTGOMERYCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25136ZIPCd
FieldValueIRS element (for citing)
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1MONTGOMERY GENERAL HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted19CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLHTTPS://MGHWV.COM/COMMUNITY-HEALTHOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt19ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLHTTPS://MGHWV.COM/COMMUNITY-HEALTHStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care120.000000000000FPGFamilyIncmLmtDscntCarePct
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLHTTPS://MGHWV.COM/FINANCIAL-RESOURCESFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLHTTPS://MGHWV.COM/FINANCIAL-RESOURCESFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLHTTPS://MGHWV.COM/FINANCIAL-RESOURCESFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Prospective Medicare MedicaidYes (X)ProspectiveMedicareMedicaidInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
MONTGOMERY GENERAL HOSPITAL, INC.PART V, SECTION B, LINE 5: INPUT WAS SOLICITED FROM THOSE REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY IN DECEMBER, 2019. DISCUSSIONS INCLUDED THE HEALTH NEEDS OF THE COMMUNITY, BARRIERS TO HEALTHCARE ACCESS, OPPORTUNITIES FOR IMPROVEMENT, PERCEPTION OF MONTGOMERY GENERAL HOSPITAL AND FEEDBACK ON MGHS INITIATIVES. THE FOLLOWING WERE SELECTED TO PROVIDE FEEDBACK: FAYETTE COUNTY DEPARTMENT OF HEALTHMONTGOMERY GENERAL HOSPITAL BOARD MEMBERSFAYETTE COUNTY SCHOOLSBRIDGE VALLEY COMMUNITY AND TECHNICAL COLLEGEFRESENIUS DIALYSIS OF MONTGOMERYCITY OF MONTGOMERY REPRESENTATIVESMONTGOMERY GENERAL HOSPITAL EMPLOYEES AND PHYSICIANS
MONTGOMERY GENERAL HOSPITAL, INC.PART V, SECTION B, LINE 11: THE RESULTS OF THE CHNA WILL ENABLE THE HOSPITAL, AS WELL AS OTHER COMMUNITY PROVIDERS, TO COLLABORATE THEIR EFFORTS TO PROVIDE THE NECESSARY RESOURCES FOR THE COMMUNITY. AFTER REVIEWING DATA SOURCES PROVIDING DEMOGRAPHIC, POPULATION, SOCIOECONOMIC, AND HEALTH STATUS INFORMATION, IN ADDITION TO COMMUNITY FEEDBACK, HEALTH NEEDS OF THE COMMUNITY WERE PRIORITIZED. THE FOLLOWING HAVE BEEN SELECTED AS THE PRIORITY HEALTH ISSUES TO BE ADDRESSED:1. PHYSICAL INACTIVITY AND OBESITYTHE FITNESS CENTER AT MGH WILL CONTINUE TO BE AVAILABLE TO ITS COMMUNITY MEMBERS FREE OF CHARGE DURING WEEKLY STAFFED HOURS. THIS STATE-OF-THE-ART FACILITY PROVIDES A WIDE VARIETY OF EQUIPMENT INCLUDING: TREADMILLS, ELLIPTICALS, STAIR-MASTERS, A SITH GYM, FREE WEIGHTS, AND RECUMBENT BIKES.2. SUBSTANCE ABUSE AND MENTAL HEALTHTHE HOSPITAL WILL MAINTAIN ITS COLLABORATION AND REFERRAL NETWORK TO ADDRESS PATIENTS' NEEDS WITH REGARDS TO ADDICTION AND ABUSE. MGH WILL CONTINUE TO PROVIDE OUTREACH AND EDUCATION TO THE RESIDENTS OF MONTGOMERY AND THE SURROUNDING COMMUNITIES.3. TRANSPORTATIONMGH OWNS TWO VANS PRIMARILY USED TO TRANSPORT ELDERLY AND LONG-TERM CARE PATIENTS. MGH WILL EXPLORE ADDITIONAL OPPORTUNITIES TO PROVIDE TRANSPORTATION FOR HEALTHCARE VISITS.4. WOMEN'S HEALTH CARELOCAL PRIMARY CARE PROVIDERS ARE PROVIDING SOME WOMEN'S HEALTH SERVICES, HOWEVER, MGH IS CONTINUING TO LOOK FOR EXTERNAL PARTNERS TO ADDRESS THE WOMEN'S HEALTH NEEDS OF THE AREA.

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 7:THE COST OF CHARITY CARE HAS BEEN CALCULATED BY OBTAINING GROSS CHARGES FROM THE AUDITED FINANCIAL STATEMENTS FOR CHARITY CARE WRITE OFFS AND MULTIPLYING THESE CHARGES BY THE AGGREGATE HOSPITAL COST TO CHARGE RATIO. THE RESULTING CHARITY CARE COST WAS THEN INCREASED FOR THE ESTIMATED "CHARITY PORTION" OF BROAD-BASED TAXES PAID TO THE STATE OF WV. THE NET AMOUNT WAS THEN REDUCED BY THE ESTIMATED "CHARITY PORTION" OF THE REVENUE "DISPROPORTIONATE SHARE" PAYMENT RECEIVED FROM THE STATE. MEDICAID COMMUNITY BENEFIT COST WAS ESTIMATED BASED ON THE COSTS IN EXCESS OF REIMBURSEMENTS FOR THE HOSPITAL'S SKILLED NURSING UNIT. OTHER HOSPITAL SERVICES ARE REIMBURSED BY WV MEDICAID AT 100% OF COST. SINCE THOSE COSTS AND REIMBURSEMENTS WOULD NET TO ZERO COMMUNITY BENEFIT EXPENSE, THOSE AMOUNTS ARE NOT INCLUDED IN THE MEDICAID COSTS AND OFF-SETTING REVENUE TOTALS REPORTED.
PART I, LINE 7, COLUMN (F):THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 3,717,715.
PART III, LINE 2:BAD DEBTS AS REPORTED ON FINANCIAL STATEMENTS.
PART III, LINE 4:PATIENT ACCOUNTS RECEIVABLE: PATIENT ACCOUNTS RECEIVABLE ARE CARRIED AT THE ORIGINAL CHARGE LESS AN ESTIMATE MADE FOR DOUBTFUL OR UNCOLLECTABLE ACCOUNTS. THE ALLOWANCE IS BASED UPON A REVIEW OF THE OUTSTANDING BALANCES AGED BY FINANCIAL CLASS. MANAGEMENT USES COLLECTION PERCENTAGES BASED UPON HISTORICAL COLLECTION EXPERIENCE TO DETERMINE COLLECTABILITY. MANAGEMENT ALSO REVIEWS TROUBLED, AGED ACCOUNTS TO DETERMINE COLLECTION POTENTIAL. PATIENT ACCOUNTS RECEIVABLE ARE WRITTEN OFF WHEN DEEMED UNCOLLECTIBLE. RECOVERIES OF ACCOUNTS PREVIOUSLY WRITTEN OFF ARE RECORDED AS A REDUCTION TO BAD DEBT EXPENSE WHEN RECEIVED. INTEREST IS NOT CHARGED ON PATIENT ACCOUNTS RECEIVABLE.
PART III, LINE 8:THE MEDICARE COSTS AND REIMBURSEMENTS WERE DERIVED FROM THE HOSPITAL'S MEDICARE COST REPORT.
PART III, LINE 9B:CHARITY APPLICATION IS AVAILABLE TO ANY PERSON INTERESTED. COLLECTION STAFF WILL MEET WITH INTERESTED PATIENT TO HELP COMPLETE AND ASSESS ALL REQUIRED INFORMATION.
PART VI, LINE 2:MONTGOMERY GENERAL HOSPITAL PROVIDES ACUTE CARE SERVICES, SWING BED SNF SERVICES, SKILLED NURSING SERVICES FOR BOTH SKILLED PATIENTS AND INTERMEDIATE CARE PATIENTS AND PHYSICIANS IN GENERAL PRACTICE AND MANY SPECIALTIES. AS THE ONLY HOSPITAL IN FAYETTE COUNTY, MONTGOMERY GENERAL HOSPITAL IS AWARE OF THE HEALTH NEEDS OF THE COMMUNITY AND WORKS TO PROVIDE ALL NECESSARY SERVICES TO ALL CITIZENS OF THE COUNTY.
PART VI, LINE 3:MGH WILL MAKE REASONABLE EFFORTS TO EXPLAIN THE BENEFITS OF MEDICAID AND OTHER AVAILABLE PUBLIC AND PRIVATE PROGRAMS TO PATIENTS AND PROVIDE INFORMATION ON THOSE PROGRAMS THAT MAY PROVIDE COVERAGE FOR SERVICES. INFORMATION ON PUBLIC OR PRIVATE COVERAGE AND MGH'S FINANCIAL ASSISTANCE POLICY WILL BE COMMUNICATED TO PATIENTS IN EASY-TO-UNDERSTAND, CULTURALLY APPROPRIATE LANGUAGE, AND IN THE MOST PREVALENT LANGUAGES SPOKEN IN APPLICABLE HOSPITAL SERVICE AREA COMMUNITIES. MGH WILL MAKE RESOURCES AVAILABLE TO ASSIST PATIENTS IN ENROLLING IN AND/OR APPLYING FOR FEDERAL AND GOVERNMENT PROGRAMS. REQUESTS FOR FINANCIAL ASSISTANCE WILL BE PROCESSED PROMPTLY AND MGH WILL NOTIFY THE PATIENT OR APPLICANT IN WRITING WITHIN 60 DAYS OF RECEIPT OF A COMPLETED APPLICATION.
PART VI, LINE 4:MONTGOMERY GENERAL HOSPITAL IS A CRITICAL ACCESS HOSPITAL LOCATED IN FAYETTE COUNTY, WEST VIRGINIA. MONTGOMERY GENERAL HOSPITAL IS THE ONLY HOSPITAL FOR RURAL FAYETTE COUNTY. FAYETTE COUNTY IS A LOW INCOME AREA THAT MUST COMPETE WITH URBAN KANAWHA COUNTY TO ATTRACT AND RETAIN PHYSICIANS, NURSES AND MEDICAL PERSONNEL. IN ADDITION OF HAVING TO PAY HIGHER SALARIES TO ATTRACT TOP MEDICAL PROFESSIONALS, MONTGOMERY GENERAL HOSPITAL HAS A HIGH PERCENTAGE OF MEDICARE AND MEDICAID PATIENT POPULATION. MONTGOMERY GENERAL HOSPITAL IS LISTED AS A HEALTH PROFESSIONAL SHORTAGE AREA AND A MEDICALLY UNDERSERVED AREA FOR PORTIONS OF FAYETTE COUNTY.
PART VI, LINE 5:THE MAJORITY OF MONTGOMERY GENERAL HOSPITAL'S BOARD OF DIRECTORS IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. THE ORGANIZATION USES SURPLUS FUNDS FOR IMPROVEMENTS IN PATIENT CARE. CURRENTLY, THE ORGANIZATION IS IN THE PROCESS OF UPDATING ALL PATIENT ROOMS AND IMPLEMENTING AN EMR. THE ORGANIZATION OPERATES AN EMERGENCY ROOM AVAILABLE TO ALL, REGARDLESS OF ABILITY TO PAY. THE ORGANIZATION OFFERS OPEN MRI SERVICES AND IS IN THE PROCESS OF IMPLEMENTING DIGITAL RADIOLOGY. THE ORGANIZATION INVOLVES ITSELF IN THE COMMUNITY BY SPONSORING HEALTH FAIRS AS WELL AS LUNCH AND LEARN OPPORTUNITIES TO ADDRESS THE DIABETIC POPULATION.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
WILLIAM CASTO MD
PHYSICIAN$394,514$0$0$0$0$0$0$0$0$0$394,514$0$0$0
DILIP GHODASARA MD
PHYSICIAN$325,700$0$0$0$0$0$0$0$0$0$325,700$0$0$0
ROBERT EGGLESTON MD
PHYSICIAN$301,874$0$0$0$0$0$0$0$0$0$301,874$0$0$0
MOHAMAD SANKARI MD
PHYSICIAN$255,346$0$0$0$0$0$0$0$0$0$255,346$0$0$0
MYRA PRIDDY MD
PHYSICIAN$245,547$0$0$0$0$0$0$0$0$0$245,547$0$0$0
VICKIE GAY
PRESIDENT & CEO$145,809$0$0$0$0$0$5,000$0$1,264$0$152,073$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS REVIEWED BY THE CFO AND CEO.
FORM 990, PART VI, SECTION B, LINE 12CANNUALLY BOARD MEMBERS ARE PROVIDED THE CONFLICT OF INTEREST POLICY AND QUESTIONNAIRE. ONCE THESE ARE COMPLETED THEY ARE RETURNED TO ADMINISTRATION AND REVIEWED BY OUR IN-HOUSE COUNSEL.
FORM 990, PART VI, SECTION B, LINE 15THE BOARD OF DIRECTORS DETERMINES THE PRESIDENT/CEO'S SALARY BASED UPON COMPARATIVE INDUSTRY STANDARDS. THE CEO DETERMINES THE CFO SALARY BASED UPON COMPARATIVE INDUSTRY STANDARDS.
FORM 990, PART VI, SECTION C, LINE 19THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. THE FINANCIAL STATEMENTS ARE PUBLISHED ANNUALLY IN THE LOCAL NEWSPAPER.
FORM 990, PART IX, LINE 11GLAB SERVICE FEES: PROGRAM SERVICE EXPENSES 384,718. MANAGEMENT AND GENERAL EXPENSES 151,212. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 535,930. LTC PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 382,881. MANAGEMENT AND GENERAL EXPENSES 150,490. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 533,371. THERAPY PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 557,030. MANAGEMENT AND GENERAL EXPENSES 218,938. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 775,968. ADMIN PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 151,768. MANAGEMENT AND GENERAL EXPENSES 59,652. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 211,420. MEDICAL PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 783,092. MANAGEMENT AND GENERAL EXPENSES 307,791. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,090,883. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 133,774. MANAGEMENT AND GENERAL EXPENSES 52,579. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 186,353.
FORM 990, PART XI, LINE 9:TRANSFERS FROM RELATED PARTIES -197,971. CHANGE IN PENSION FUNDED PLAN STATUS 910,464.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
LAIRD HEALTH CARE FOUNDATION INC
WASHINGTON SIXTH AVENUEMONTGOMERYWV25136550632743SUPPORT TAX-EXEMPT HEALTH CARE ORGANIZATIONSWV501(C)(3)LINE 7MONTGOMERY GENERAL HEALTH CARE SYSTEM0
MONTGOMERY GENERAL ELDERLY CARE CENTER
WASHINGTON SIXTH AVENUEMONTGOMERYWV25136550623339EXTENDED CARE FACILITYWV501(C)(3)LINE 11MONTGOMERY GENERAL HEALTH CARE SYSTEM0
MONTGOMERY GENERAL HEALTH CARE SYSTEM INC
WASHINGTON SIXTH AVENUEMONTGOMERYWV25136550632601PROVIDE SUPPORT TO AFFILIATED EXEMPT HEALTH CARE PROVIDERSWV501(C)(3)LINE 12C, III-FI0N/A
MONTGOMERY MEDCORP INC
WASHINGTON SIXTH AVENUEMONTGOMERYWV25136550767169PHYSICIANS PRACTICEWV501(C)(3)LINE 11MONTGOMERY GENERAL HEALTH CARE SYSTEM0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd